Indiana Nursing Homes >> Madison Nursing Homes >> Hickory Creek At Madison

Hickory Creek At Madison - Madison Nursing Home

General Information

UPDATE
Federal Provider Number
155427
Provider Name
HICKORY CREEK AT MADISON
Provider Address
1945 CRAGMONT ST
MADISON, IN 47250
Provider Phone Number
(812) 273-4696
Provider SSA County
380
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
36
Number of Residents in Certified Beds
35
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HENRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.87143
Reported LPN Staffing Hours per Resident per Day
0.61857
Reported RN Staffing Hours per Resident per Day
0.68143
Reported Licensed Staffing Hours per Resident per Day
1.30000
Reported Total Nurse Staffing Hours per Resident per Day
4.17143
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12714
Expected CNA Staffing Hours per Resident per Day
2.49667
Expected LPN Staffing Hours per Resident per Day
0.62901
Expected RN Staffing Hours per Resident per Day
1.02804
Expected Total Nurse Staffing Hours per Resident per Day
4.15373
Adjusted CNA Staffing Hours per Resident per Day
2.82201
Adjusted LPN Staffing Hours per Resident per Day
0.81622
Adjusted RN Staffing Hours per Resident per Day
0.49528
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04808
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-04-04
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-02-07
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2011-12-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
0.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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